AMA (NSW) President: health risks of codeine outweigh benefits

AMA (NSW) President, Prof Brad Frankum, says the Therapeutic Goods Administration decision to make codeine available by prescription-only from 1 February 2018 correctly reflects the health risks of this medicine.

“Codeine is an opioid drug that is derived from poppies. It is metabolised into morphine in the liver and people can become addicted to it if used for chronic pain.

“Codeine becomes less effective for patients who develop a tolerance, and over time they need higher and higher doses to feel relief from symptoms. There are also multiple side-effects including sedation and constipation.

“And when the medicine is stopped, some patients experience severe withdrawal symptoms such as head and muscle aches, nausea, diarrhoea, insomnia and mood swings.

“These withdrawal symptoms often mimic the very ailments patients were trying to control with codeine, which in turn leads some patients to continue taking codeine or in higher doses,” Prof Frankum said.

For some patients, codeine is a gateway drug to other opiates.

“Prescription narcotics are now the most common cause of overdose deaths.

“This is why the Therapeutic Goods Administration has decided to make medicines that contain low-dose codeine by prescription-only,” Prof Frankum said.

“It is an appropriate measure to take and one that is already in place in many countries in the world. In most of Europe, the UAE and Japan, medicines containing codeine can only be bought with a prescription.

“Attempts to delay or undermine the TGA’s decision are putting public safety at risk.

“Pharmacists cannot know the background medical history of patients in depth and can’t be expected to make therapeutic decisions on patients with chronic complex pain syndromes.

“Pharmacists are contradicting themselves when they say they want real-time prescription monitoring in cooperation with doctors, at the same time as wanting to dispense codeine without a prescription or scrutiny from doctors.

“For short-term pain and cough or cold symptoms, patients will still have access to products containing paracetamol or ibuprofen – or medicines which combine the two. Both are effective in helping most people manage acute pain.

“What patients may not realise is that over-the-counter painkillers with codeine offer very little additional benefit when compared with painkillers without codeine, but substantially more risk.

“No amount of lost profit from selling these medicines is worth the cost to Australians’ health,” Prof Frankum said.

Media contact: Andrea Cornish 0419 402 955